Physician Compare National (NPI:1851549901)

HEALTHCARE PROVIDER: KYLE J HAZELWOOD M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1851549901
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3476787805
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20170923000545
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	HAZELWOOD
	Individual professional last name
Provider First Name	KYLE
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	LOYOLA UNIVERSITY OF CHICAGO, STRITCH SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2007
	Individual professional's medical school graduation year
Primary Specialty	ORTHOPEDIC SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	825 SE BISHOP BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 120
	Group Practice or individual's line 2 address
City	PULLMAN
	Group Practice or individual's city
State	WA
	Group Practice or individual's state
Zip Code	991635517
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	501331
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	PULLMAN REGIONAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	131327
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	GRITMAN MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y